Florida Senate - 2020                                     SB 116
       
       
        
       By Senator Cruz
       
       
       
       
       
       18-00074-20                                            2020116__
    1                        A bill to be entitled                      
    2         An act relating to prescription insulin drugs;
    3         creating ss. 627.64085 and 627.65746, F.S.; defining
    4         the term “prescription insulin drug”; requiring
    5         individual and group health insurance policies,
    6         respectively, to cap an insured’s monthly cost-sharing
    7         obligation for covered prescription insulin drugs at a
    8         specified amount; providing construction; authorizing
    9         the Financial Services Commission to adopt rules;
   10         amending s. 641.31, F.S.; defining the term
   11         “prescription insulin drug”; requiring health
   12         maintenance contracts to cap a subscriber’s monthly
   13         cost-sharing obligation for covered prescription
   14         insulin drugs at a specified amount; providing
   15         construction; authorizing the commission to adopt
   16         rules; providing an effective date.
   17          
   18  Be It Enacted by the Legislature of the State of Florida:
   19  
   20         Section 1. Section 627.64085, Florida Statutes, is created
   21  to read:
   22         627.64085 Cost sharing for prescription insulin drugs;
   23  limits.—
   24         (1) As used in this section, the term “prescription insulin
   25  drug” means a prescription drug that contains insulin, is used
   26  to treat diabetes, and has been prescribed as medically
   27  necessary by the treating physician.
   28         (2) A health insurance policy that provides coverage for
   29  prescription insulin drugs must cap the total amount of cost
   30  sharing that an insured is required to pay for a covered
   31  prescription insulin drug at an amount not to exceed $100 per
   32  30-day supply of the insulin drug, regardless of the amount or
   33  type of insulin needed to fill the insured’s prescription.
   34         (3) This section does not prevent an insurer from reducing
   35  an insured’s cost-sharing obligation by an amount greater than
   36  the amount specified in subsection (2).
   37         (4) The commission may adopt rules to administer this
   38  section.
   39         Section 2. Section 627.65746, Florida Statutes, is created
   40  to read:
   41         627.65746 Cost sharing for prescription insulin drugs;
   42  limits.—
   43         (1) As used in this section, the term “prescription insulin
   44  drug” means a prescription drug that contains insulin, is used
   45  to treat diabetes, and has been prescribed as medically
   46  necessary by the treating physician.
   47         (2) A group health insurance policy that provides coverage
   48  for prescription insulin drugs must cap the total amount of cost
   49  sharing that an insured is required to pay for a covered
   50  prescription insulin drug at an amount not to exceed $100 per
   51  30-day supply of the insulin drug, regardless of the amount or
   52  type of insulin needed to fill the insured’s prescription.
   53         (3) This section does not prevent an insurer from reducing
   54  an insured’s cost-sharing obligation by an amount greater than
   55  the amount specified in subsection (2).
   56         (4) The commission may adopt rules to administer this
   57  section.
   58         Section 3. Subsection (48) is added to section 641.31,
   59  Florida Statutes, to read:
   60         641.31 Health maintenance contracts.—
   61         (48)(a) As used in this subsection, the term “prescription
   62  insulin drug” means a prescription drug that contains insulin,
   63  is used to treat diabetes, and has been prescribed as medically
   64  necessary by the treating physician.
   65         (b) A health maintenance contract that provides coverage
   66  for prescription insulin drugs must cap the total amount of cost
   67  sharing that a subscriber is required to pay for a covered
   68  prescription insulin drug at an amount not to exceed $100 per
   69  30-day supply of the insulin drug, regardless of the amount or
   70  type of insulin needed to fill the subscriber’s prescription.
   71         (c) This subsection does not prevent a health maintenance
   72  organization from reducing a subscriber’s cost-sharing
   73  obligation by an amount greater than the amount specified in
   74  paragraph (b).
   75         (d) The commission may adopt rules to administer this
   76  subsection.
   77         Section 4. This act shall take effect January 1, 2021.